Community empowerment is the key to containing coronavirus in Somalia

On 16th of March 2020, the Federal Government of Somalia (FGS) confirmed the first confirmed Covid-19 case in the country. The patient was a Somali citizen returning from China. 

Eleven days later, the country reported its third Covid-19 cases. Two of the patients were Somali citizens returning from overseas, while the third was a foreign national working for the UN mission in Somalia. Currently, Somalia has five total confirmed cases.

To curb the spread of the virus, the FGS closed down educational institutions, suspended all domestic and international flights, earmarked $5 million to combat the outbreak and embarked on a public awareness campaign to ensure the public absorbs prevention measures and strengthens hygiene. 

The government distributed preventive medical items (face masks, testing kits, and protective clothing) donated by Chinese billionaire Jack Ma to 54 African countries. The country even sent 20 doctors to help Italy contain the deadly pandemic.

Challenges

However, Somalia's capacity to manage the Covid-19 public health threat is a cause for concern. 

The country's health infrastructure is severely undermined due to years of conflict and the state's fragility. Somalia's Ministry of Health suffers from a shortage of equipment, in particular ICU and ventilator capacity, medicines and qualified health workers. 

There is even a possibility the Chinese testing kits donated to Somalia may not work correctly given the experiences of countries that found some Chinese equipment faulty. 

Another challenge is the conflict and protracted displacement across the country. There are about 2.6 million internally displaced persons (IDP) in Somalia, who often live in overcrowded and under-served camps. 

IDPs are at risk because they live in confined environments, often in unhygienic and unsanitary conditions with little access to clean water, and people in the camps are already exposed to several illnesses.

Many people in the camps have underlying conditions, and child malnourishment is a protracted challenge. 

What makes matters even worse is the spread of misinformation on the pandemic. There's a persistent narrative among the society that Covid-19 is a hoax engineered by the political elite to accumulate money from aid donors or that the disease does not kill practising Muslims.

The armed conflict in Somalia didn't even skip a beat when the first confirmed case of Covid-19 was announced. The Al Qaeda-linked Al Shabaab continues to launch deadly operations against state targets while not allowing genuine coronavirus-related information to disseminate in the areas it controls. Their narrative is that it is "spread by crusader forces who have invaded the country" threatening people against taking foreign aid. The good news is that Muslim clerics in the country have tried to counter Al Shabaab's propaganda.

Al Shabaab's attacks come against the backdrop of a plea from UN Secretary-General Antonio Guterres earlier last week for an immediate global ceasefire in all conflicts to "focus together on the true fight" against Covid-19. 

Al Shabaab's attacks and its clashes with Somali security forces will accelerate the displacement and movement of people, compounding the situation and hindering efforts to contain a broader outbreak.

Last but not least, there is a cultural barrier stemming from Somalia's culture of communal living — a standard practice, in which extended (and usually numerous) family members live together in dense, overcrowded homes. 

The country has a social culture where gatherings are frequent and visiting sick people is commonplace. 

Poverty is, of course, the elephant in the room. The fact that the majority of Somali households survive on daily wages is an extremely challenging issue to tackle that even more developed countries are struggling to counter. 

The plague of locusts already undermined the country's food security, and it is almost impossible to isolate the majority of Somalis in their homes without compromising their livelihoods or providing assistance. 

Somalia's only advantage is that approximately 70 percent of its population is under the age of 30. However, after decades of living under a crumbling health system, many have underlying conditions and poor access to quality healthcare which might nullify the stronger immunity that youth provides.

A roadmap

Somalia is still at a very early stage of the spread. Despite the challenges, Somali authorities can manage the Covid-19 public health threat through leadership and good governance. 

Strong public communication comes first. In this regard, information posters on the pandemic should be widely distributed in public places/markets, regular TV and Radio programs should be broadcasted, and public transport should be disinfected. 

Religious figures, celebrities and opinion leaders should regularly take to social media. The use of mobile money in all business and governmental transactions should be strictly encouraged.

Second, defeating Covid-19 requires leveraging and unleashing the power of the communities. In West Africa, the Ebola epidemic from 2014 onwards demonstrated that the community is vital for stopping the disease. 

The FGS is unable to deliver health services to all of its citizens, so it is best to empower communities to take action in community-based surveillance, monitoring, and care. 

Third, comes FGS and federal member states' cooperation for response coordination. Increased collaboration between the two levels of the government is paramount to tackling the new public health threat by ensuring a timely response. A coordinated public-private partnership is also crucial for effective prevention. 

Fourth, the FGS should engage Al Shabaab with the hope to reach a ceasefire so that there is a focused fight against the pandemic. The armed group should play its part and ensure that accurate and responsible information and aid from the government and NGOs reach people living under its territory.

Fifth, no country is an island. Somalia should engage with its neighbours and regional organisations to prevent the spread of the pandemic and address the economic problems it creates. 

Such a pan-African strategy will play a critical role in the coordination of the cross-border responses and surveillance and helps information-sharing. 

Finally, Somalia alone cannot defeat the disease. The FGS should seek international emergency help from multilateral organisations like the World Bank, IMF and WHO, and developed countries, especially its development partners. 

Emergency assistance should comprise direct budgetary support, additional equipment (masks, ICU beds, ventilators, protective clothes, etc.), and funds to help its health system as well as debt relief measures.